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Eleven Republican governors, including Florida's Rick Scott, Louisiana's Bobby Jindal and Arizona's Jan Brewer want to meet with President Barack Obama to discuss the federal health overhaul, including ways to make expanding the Medicaid rolls and setting up online health exchanges more affordable for states with tight budgets.
The letter requesting the meeting comes after the Obama administration said Monday that states can do a partial Medicaid expansion but that they wouldn't get the three years of 100 percent federal funding provided under the law. Scott had previously requested to meet with Health and Human Services Secretary Kathleen Sebelius to discuss his concerns that the law could burden state taxpayers.
Scott has been a vocal critic of the Affordable Care Act, but softened his position after the election, saying he's open to working with federal health officials to find a solution. But he's repeatedly expressed concerns about the potential costs to Florida taxpayers. Now he's one of several Republican governors who recently sent a letter asking for more flexibility in the laws so that states can tailor the programs to their individual needs.
Signing the letter along with Scott were governors from Iowa, Utah, Maine, Virginia, Ohio, South Dakota, Wyoming, Arizona, Louisiana and Mississippi.
The governors made several suggestions that included asking that states be allowed to determine their own Medicaid eligibility levels and still receive all the federal funds. They also raised the possibility of imposing "reasonable and enforceable-cost sharing requirements" and worried that the process for determining newly eligible Medicaid beneficiaries could become an "overly difficult audit procedure at the end of the year" potentially jeopardizing billions of dollars in payments to the states.
The governors also said they want to be able to leverage their private health insurance markets to reduce dependency on entitlement programs.
"The President and his team have met with state leaders for more than two and a half years," said Erin Shields Britt, a spokeswoman for the Department of Health and Human Services. "The President has welcomed an open dialogue with the nation's governors, one on one and as a group and Secretary Sebelius has offered to meet with Governor Scott."
For now Florida has defaulted into letting the federal government run the health exchange because lawmakers chose not to run their own exchange, an online marketplace where residents and small businesses can shop for health care coverage. They could change their mind later and pursue a partnership with the feds, but that would take approval by the Legislature and governor.
But they still must decide whether they will expand Medicaid rolls. Officials estimate close to 900,000 residents could be covered under expanded Medicaid rolls by fiscal year 2020-2021, costing the state $330 million.
A Senate committee charged with overseeing the implementation of the health law had its first meeting just last week and seemed far from making any decisions.
Sen. Joe Negron reminded the committee that the state will spend about $21 billion on Medicaid this year. Medicaid covers nearly 3 million people — about half are children. Lawmakers say it must be overhauled because it's eating up about 30 percent of the state budget.
If Florida lawmakers decide to fully expand their Medicaid rolls, the Obama administration is offering to absorb the cost for the first three years and pick up 90 percent of the tab after that.
Florida has one of the highest rates of uninsured rates and some of the most stringent eligibility requirements in the country for Medicaid. A family of three with income of $11,000 a year makes too much and single residents are not covered.